Healthcare Provider Details

I. General information

NPI: 1205406394
Provider Name (Legal Business Name): COMPASSION HEALTH TOLEDO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2021
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1638 BROADWAY ST
TOLEDO OH
43609-3240
US

IV. Provider business mailing address

1638 BROADWAY ST
TOLEDO OH
43609-3240
US

V. Phone/Fax

Practice location:
  • Phone: 567-661-0565
  • Fax:
Mailing address:
  • Phone: 567-661-0565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANNE BAUMAN
Title or Position: CHIEF OF OPERATIONS
Credential:
Phone: 567-661-0565